MANAGER, RISK MANAGEMENT (COLLISION INVESTIGATIONS)

Manages and oversees the activities of one or more areas within Risk Management, including Workers' Compensation Claims Administration, General Liability Claims Administration, Investigations, and Risk Financing.Manages and conducts complex planning, implementation, funding, and analytical projects and programs for Risk Management functionsSupports executive management in the development and implementation of strategic objectives in assigned areaManages staff, consultants, and/or projects.Manages and oversees operational audits in assigned areaRecommends investigations based on claim information, circumstances, etc.Ensures staff's understanding and strict compliance with all confidentiality provisions under relevant State of California Insurance Code, California Government Code, Labor Code, etc.Develops red flag assessment protocols for injury/illness occupational and general liability claimsSupervises intensive data mining reviews of information related to injured workers to determine appropriateness of intensive investigation and surveillance requirements to combat workers' compensation fraud and abuseOrganizes and provides guidance to risk management staff regarding complex investigations and case development in the area of claims management and accident collision investigationsResponds to accident scenes and supervises, and reports back on incidents/accidentsAnalyzes trends and develops programs and other measures to reduce claims exposureReports, summarizes, and communicates findings to appropriate area, level, or statutory reporting agencyParticipates in assessment of claims with County Counsel for concurrence before local government and state level reportingInvestigates, adjusts, and manages claims caseload; settles claims in collaboration with affected Division staff and CounselWorks with appropriate prosecuting and law enforcement agencies including State of California Department of Insurance, State of California Fraud Division’s Anti-Fraud Programs, State of California Department of Industrial Relations Division of Workers' Compensation, and local District Attorney's OfficesManages and/or conducts training for personnel and all other interested personnel with respect to risk management, including fraud awareness and recognitionPrepares narrative, graphic, and statistical reports for executive and Board presentations, and internal reviewDevelops policies and procedures for assigned areaSupports all internal departments with risk management needsPartners and communicates with other departments to administer programs and achieve agency goalsRecommends corrective action to resolve problems, abuses, and deficiencies that may existComplies with Metro's bill paying standards to ensure project and cost center invoices are paid in a timely mannerCommunicates and implements safety rules, policies, and procedures in support of the agency's safety vision and goals; and maintains accountability for the safety performance of all assigned employeesContributes to ensuring that the Equal Employment Opportunity (EEO) policies and programs of Metro are carried outMay be required to perform other related job duties

A combination of education and/or experience that provides the required knowledge, skills, and abilities to perform the essential functions of the position. Additional experience, as outlined below, may be substituted for required education on a year-for-year basis. A typical combination includes:EducationBachelor's Degree in Public Administration, Business Administration, or a related fieldExperienceSix years of relevant experience or three years of relevant supervisory-level experience in one or more risk management functions such as workers’ compensation, general liability, risk financing, and/or investigations programs; some positions in this class may require specialized experience in area of assignmentCertifications/Licenses/Special RequirementsA valid California Class C Driver License or the ability to utilize an alternative method of transportation when needed to carry out job-related essential functionsCertified Professional in Fraud Identification (CPFI), insurance fraud investigator, private investigator license, or law enforcement training in investigation preferredCalifornia Workers' Compensation Self-Insured Certificate preferredPreferred Qualifications (PQs)

are used to identify relevant knowledge, skills, and abilities (KSAs) as determined by business necessity. These criteria are considered preferred qualifications and are not intended to serve as minimum requirements for the position. PQs will help support selection decisions throughout the recruitment. In addition, applicants who possess these PQs will not automatically be selected.Experience handling claims or investigations related to general liability, property casualty, auto-accident or workers’ compensationExperience identifying and reporting insurance fraud and working with state or local law enforcement prosecution officesExperience investigating traffic collisions, collision reconstruction, or related areasExperience leading or managing projects related to risk managementKnowledge of

(defined as a learned body of information that is required for and applied in the performance of job tasks)Theories, principles, and practices of workers’ compensation claims administration, general liability claims administration, risk financing, and investigationsApplicable local, state, and federal laws, rules, and regulations governing insurance code, government code, labor code, criminal investigations, and risk financingStrategies and procedures of case settlementsCalifornia Government Code and Rules of Civil Procedure and rules and practices of the local Superior and Municipal CourtsClaims investigation protocolsPersonal injury analysis and evaluations, and wrongful death claimsGeneral and auto liability claimsElements of tort lawInvestigating claims and determining reasonable settlementsSpecialized investigative techniques, intelligence gathering, and examination methodsResearch and report preparation methodsEEO and Affirmative Action rules and regulationsModern management theoryApplicable business software applicationsSkill in

(defined as the proficient manual, verbal, or mental utilization of data, people, or things)Overseeing the operations of workers’ compensation, general liability, investigations, or risk financing programExercising appropriate administrative recommendations and actions based on findings and developmentsAnalyzing situations and identifying problemsPreparing and reviewing comprehensive reports and correspondenceExercising sound judgment and creativity in making decisionsCommunicating effectively orally and in writingInteracting professionally with various levels of Metro employees, Office of Inspector General, other law enforcement and prosecutorial agencies, and various outside representativesSupervising, training, and motivating assigned staffAbility to

(defined as a present competence to perform an observable behavior or produce an observable result)Recognize sensitive issues and manage the activities of assigned staff accordinglyDevelop and promote positive working relations within the cabinet, other Metro departments, as well as with outside law enforcement and regulatory agenciesDevelop and deliver quality projects from inception to close-out, on time, and within scope and budgetMeet tight time constraints and deadlinesThink and act independentlyUnderstand, interpret, and apply laws, rules, regulations, policies, procedures, contracts, budgets, and labor/management agreementsCompile and analyze dataConduct administrative and criminal investigationsRepresent Metro before the publicTravel to offsite locationsRead, write, speak, and understand EnglishSpecial ConditionsThe physical demands described are representative of those that must be met by the employee to successfully perform the essential functions of this job. Metro provides reasonable accommodation to enable individuals with disabilities to perform the essential functions.Working ConditionsTypical office situationClose exposure to computer monitors and video screenWork irregular hours, split shifts, weekends, holidays, or 24-hour-a-day on-call assignmentsWork after designated regular hours in case of special assignments or emergenciesLocal travelPhysical Effort RequiredSitting at a desk or tableOperate a telephone or other telecommunications device and communicate through the mediumType and use a keyboard and mouse to perform necessary computer-based functionsStandingWalking (distance 5' to 100')Communicating through speech in the English language required

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